Investigation of anemia in patients with terminal malignant tumors

Objective：To analyze the incidence and severity of anemia in patients with terminal malignant tumors (MT), for the purpose of providing reference for improving the supportive treatment of patients with malignant tumor. Methods：A total of 2 037 patients diagnosed with MT in Zhongshan Hospital, Fudan University from 2004 to 2014 were included, and blood routine examinations of the patients during their last year of life-span were evaluated. The proportion of anemia and severe anemia, and the average level of hemoglobin of the patients within the last 12 months, 9 months, 6 months, 3 months, and 1 month of their life. Results：The proportions of anemia in patients with terminal MT within the last 12 months, 9 months, 6 months, 3 months, and 1 month of their life were 79.79%, 82.23%, 82.77%, 90.34%, and 95.33%, with significant differences among different time points (P=0.000), and the proportions of severe anemia were 5.67%，3.05%，6.72%，9.66%, and 18.00%, correspondingly, with significant differences among different time points (P=0.000). The average levels of hemoglobin during the last year of the patients’ life decreased significantly as the disease progressed, also with significant differences among different time points (P=0.000). The average hemoglobin level in the first month and the third month before the death of the patient was significantly lower than that at each time point 6 months before the death (P=0.000). The average hemoglobin level in the first month before death was lower than that in the third month before death (P=0.000). There was no significant difference in the average hemoglobin level among 6 months, 9 months and 12 months before the death of the patient. Conclusions：The proportion of anemia and severe anemia requiring blood transfusion in patients with terminal MT increased during the last year of their life as death approaching. The degree of anemia was significantly increased 3 months before the death of the patients with terminal MT. For these patients, anemia examination and enhanced support treatment is of great importance.